Minimal residual disease (MRD) has the potential to quickly identify acute lymphoblastic leukemia (ALL) patients at high risk for disease relapse and inform post-induction treatment strategies. Its role in predicting patient prognosis has been known since the mid-1990s, but it was not routinely incorporated into trial designs before 1999. Until this study, relative significance of MRD was unknown in comparison to other well-established factors for risk stratification, including age, white blood cell count (WBC) at diagnosis, genetic alterations, and post-induction bone marrow morphology.

To assess the role of end-induction MRD in prognosis of childhood ALL, particularly in relation to previously demonstrated clinical and genetic features used for risk stratification.

Prospective, multi-institutional study from 2000 to 2005.